The Importance of Orthostatic Radiography in the Management of Thoracolumbar Fractures: Case Report

Abstract

Patients who are victims of traumatic injuries in the spine are evaluated by radiological protocols, as recommended by Advanced Trauma Life Support (ATLS), including a computed tomography (CT) scan with the patient in the decubitus position. Spine fractures considered stable with initial nonoperative management should be further evaluated with a standard simple plain radiograph in orthostasis and/or a magnetic resonance image (MRI), to exclude any associated ligament injury and avoid neurological damage caused by occult instabilities. We present an illustrative case with an injury diagnosed through orthostasis X-ray to discuss its importance in the management of thoracolumbar fractures.

Resumo

Pacientes vítimas de lesões traumáticas na coluna são avaliados por protocolos radiológicos, conforme recomendado pelo Advanced Trauma Life Support (ATLS), incluindo uma tomografia computadorizada (TC) com o paciente em decúbito. Fraturas de coluna consideradas estáveis com tratamento inicial não operatório devem ser avaliadas posteriormente com uma radiografia simples padrão em ortostase e/ou uma ressonância magnética (RM), para excluir qualquer lesão ligamentar associada e evitar danos neurológicos causados por instabilidades ocultas. Apresentamos um caso ilustrativo com uma lesão diagnosticada por meio de raio-X em ortostase para discutir sua importância no tratamento de fraturas toracolombares.

Keywords

thoracolumbar fracture - orthostatic X-ray - conservative management - instrumented fusion

Palavras-chave

fratura toracolombar - radiografia ortostática - tratamento conservador - fusão instrumentada

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